PCC Gift of Stock or Mutual Funds Form

Thank you for your interest in donating stock / mutual funds to support the ministry of PCC. The following form is a tool to help us make sure that when your donation is received, your intentions for the gift are honored and we have the information we need to credit the gift to you. This form does not initiate the transfer of funds but the information your broker needs to initiate the transfer is below – please share it with your broker.

Your name *

Email address *

Donor Information

Address *

Phone number *

Information about Donor's Broker

Broker's Name *

Investment Firm *

Phone number

Address

Gift Information

Name of Stock / Fund

Quantity of Shares

Contribution to be Applied to Peninsula Community Chapel's: *

Local Ministry Fund

Building Fund / Capital Campaign

Other

If other or multiple, where and how do you want the contribution to be applied?

Please let us know where to use your funds and let us know how to split them if you want them used in more than one way.

PCC Account Information: Transfer of Stock / Securities / Mutual Funds

Merrill Lynch Account Number: 708-02200 / DTC #0671
For: Peninsula Community Chapel / Tax ID: 54‐1392108 / 4209 Big Bethel Road, Yorktown, VA 23693

PCC Contact Information

Peninsula Community Chapel
4209 Big Bethel Road
Yorktown, VA 23693
Attention: Becki Peek ‐ (757) 867‐8530

A copy of your responses will be sent to your email address.